Squirtle Squad: Calming Your Vagina After Birth
So, I've just learned what a "Squirtle" is; for those of you not in the know, it's a turtle-type Pokémon. Yeah, I'm not sure either. But I was tagged in a Facebook status that mentioned them, so naturally, assuming it was in one of the many pregnancy, birth, or baby groups I'm a part of, my mind started to wander—clearly this was the newest tool for perineal health after baby! "The Squirtle! Your postpartum body's best friend."
Wrong. But, it did get me thinking. If I, someone who spends a lot of time talking about "lady bits" and their involvement in birth was confused, how is everyone else supposed to know the difference between an Epi-no and a peri-bottle? How do we navigate healing from an episiotomy? What do the degrees of tears mean? There's so much to think about, all these secrets our mothers dared not whisper, things not discussed in polite company...well you know what? It's time to talk about, get it out in the open and get the information you need before you need it!
Let's start with the basics. It's not a va-jay-jay, or a cha-cha. It's a vagina. Well, technically what most of us refer to as a vagina, is actually the vulva. Everyone's vulva is different. The labia minora and labia majora (the inner and outer lips of the vagina) can vary in size, shape and even colour! A little anatomy here. The vagina is the interior part that the baby travels down to enter the world. At the top your vaginal opening is the clitoris, a bit below that is the urethra; and yet below that is the vaginal opening. Between the vaginal opening and the rectum is the perinium, a diamond-shaped area of muscle and skin that stretches and is the focus of everyone who’s about to give birth, because it can tear.
And speaking of tears, sometimes, as the baby is born, the perineum needs a little extra space, or the perineum is too tight, or hasn’t thinned itself completely, or is a bit swollen from extended pushing, leading to tearing. Four types of tears can happen during birth and are classified by "degree." A 1st degree tear is one in which the skin only is involved, a 2nd degree includes any amount of muscle, and is the most common. A 3rd degree tear reaches the rectum, and a 4th degree is one that involves the musocal membrane of the rectum. Both third and fourth-degree tears are uncommon and are always repaired carefully by an obstetrician. First and second-degree tears will sometimes require stitching, typically a running suture, rather than several stitches that are tied off. You won’t get an amount of how many stitches it took to make the repair because of this. Your caregiver will take their time to ensure everything is where it needs to be, and they do a fantastic job, so don't be worried if it seems to be taking awhile.
Within the first two hours after you give birth, you'll have to attempt to go to the bathroom. It’s scary business, but it's super important to empty your bladder to ensure your uterus remains firm. Your best friend in the coming days will be the peri-bottle, a small squeeze bottle you'll fill with warm water to help dilute the urine and reduce stinging. The peri-bottle will also eliminate the need for toilet paper, as wiping tender tissue is never a good idea! Most find it useful to start spraying before the urine releases, and to pat themselves dry after.
Another best friend will be ice packs, or what some of us lovingly call “padsicles.” They're nothing fancy, just a maxi pad lightly wetted and frozen. Your perineum will be swollen, and an ice pack can be helpful in reducing inflammation and discomfort. Just alternate on and off. You don’t want to freeze yourself down there either! You don't need to make a million, a few is enough to get you started when you get home, and a diaper can also be used in a pinch.
Something else that can be heavenly is a sitz bath! Basically, you park your bottom in a bowl of warm water to help heal, soothe and clean your perineum. Many hospitals have these in the showers of the postpartum rooms. Consider doing this a few times a day, just make sure you thoroughly pat yourself dry afterwards.
Your vagina/vulva/lady bits, whatever you want to call it, are about to become a big topic of conversation. Arm yourself with knowledge before you go into labour, so you will have all the tools and terminology figured out before you need them.
Heather is a certified DONA birth and postpartum doula, certified Lamaze childbirth educator, certified breastfeeding educator, as well as a certified Henna artist. She has been an active Calgary doula for the past eight years, is the past-president of the Calgary Doula Association, and was the former provincial representative of Alberta (SPAR) for DONA International. Heather is also a birth doula trainer and the owner of Doula Essentials. She is well-known within the international doula community and greatly respected by the medical providers in the city of Calgary and surrounding areas. She takes great pride supporting her clients through the entire journey to parenthood, from prenatal education through to breastfeeding support.